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Once again, Ontario’s medical watchdog has shown it is more interested in finding ways to preserve doctors’ privileges than in protecting patients.

In the latest case, reported by Laura Armstrong in Thursday’s Star, a Mississauga physician who admits that he sexually assaulted as many as 13 female patients is back practising medicine with the blessing of the College of Physicians and Surgeons of Ontario.

The province has legislation that decrees zero tolerance for sexual assault among doctors. But, incredibly, the college managed to find a loophole that allows Dr. Sastri Maharajh to practise medicine after a suspension of only eight months — as long as he treats male patients only.

To make matters worse, the disciplinary committee that handled the complaint against Maharajh believes he is at great risk of reoffending. It concluded that he failed to take responsibility for his actions and lacked insight into his behaviour.

The college should give its head a shake and revisit this absurd decision. It also needs to be open about whether it contacted the police when it learned about the pattern of assault in this case.

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Maharajh’s assaults came to the attention of the college in 2011 after a female patient complained that he cupped her nipple with his mouth during a breast examination. The doctor later admitted to either placing his mouth or resting his cheek on the breasts of as many as 13 female patients.

His excuse? He’d lost all control and was not conscious of what he was doing. He was going through a bad patch, was sometimes suicidal and was abusing alcohol. According to the college’s decision: “The ‘next thing he knew,’ his mouth was on her nipple. He described himself as feeling dizzy, out of touch, having lost his higher thinking and his control; his actions were ‘semi-automatic’.”

Maharajh’s psychiatrist went further. He argued that the doctor’s behaviour was not sexual in nature, but a search for a familiar “psychological nurturing” by a man who had been breastfed as a child.

None of these explanations give us confidence in the doctor’s ability to treat patients — of either gender. To state the obvious: physicians have a particularly close and physical relationship with their patients. Trust is paramount.

So what loophole is the college hiding behind? The law requires a mandatory revocation of a doctor’s licence only in cases that involve sexual intercourse, various forms of contact with the genitals, the anus and the mouth, and masturbation. It doesn’t specify that a doctor must lose his licence because of what Maharajh admitted to doing – however intimate and sexual it was.

Still, the college has the power to revoke his licence permanently. It should do so to follow the intent of the law, rather than narrowest possible interpretation.

As Trudo Lemmens, a health law and policy expert at the University of Toronto told the Star, it would be reasonable to revoke a doctor’s licence even for less-severe sexual transgressions if patients are in a “particularly vulnerable situation.” That certainly applies to a woman undergoing a breast exam.

Not revoking the doctor’s licence permanently isn’t the college’s only misstep in this sordid affair.

The college won’t say whether it contacted police about the assaults, and the law does not require it to do that. (Peel Police say his name has not appeared on an arrest report.)

Consider: if the doctor had assaulted a woman on a streetcar instead of in his office, the driver would doubtlessly have called police. Should we expect less from a professional college charged with protecting patients? The public needs to be reassured that the college passes information on possible criminal wrongdoing by its members on to police.

Who knows how many other women may have been assaulted but have not had the courage to come forward — but might if police were investigating?

Beyond this case, the province’s College of Physicians and Surgeons needs to revisit its approach to the issue of sexual misdeeds by its members. If it can’t be trusted to support zero tolerance on this crucial matter, the act should be amended to close the loopholes that led to this sorry outcome.

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